Intraoperative autotransfusion in primary hip arthroplasty. A randomized comparison with homologous blood

Abstract

To study the quality and effect of blood produced by the cell saver compared with homologous blood in total hip arthroplasty, 40 patients were randomly divided into two groups. One group received autologous blood using the cell saver, whereas the second group served as a control, and received homologous bank blood. Hematologic and coagulation parameters of the patients were assessed both preoperatively and postoperatively. Samples from the autologous and the homologous blood were obtained before reinfusion, and were assessed as regards hematologic and biochemical parameters. The autologous blood satisfied all the intraoperative transfusion requirements of the autologous group and 75 percent of the total transfusion requirements. The operative and postoperative blood losses--hence, the total blood loss--were less in the autologous than in the control group. The autologous blood had a high hemoglobin, white blood cell, and plasma hemoglobin content and MCV compared with the homologous blood. Postoperatively, there were no differences as regards the hematologic parameters studied. There was no evidence of intravascular hemolysis in the autologous group. Postoperatively, in both groups, AT III, plasminogen, and protein C decreased. Other coagulation parameters were within normal limits in both groups. Intraoperative autotransfusion is safe and effective, and should be considered in hip arthroplasty to reduce the risks associated with homologous blood transfusion.